Low profile retention system

ABSTRACT

Medical devices for retaining an end of a medical tube. Each of the devices of the present invention comprises a base and at least one tab having a portion that is moveable within the base. The base comprises an upper surface, a lower surface, at least one side cavity for receiving a tab, and an opening transverse to the upper and lower surfaces. To facilitate tube retention, the tube is inserted through the opening in the base and the tab(s) is(are) moved within the cavity(ies) such that a portion of each tab contacts and retains the tube.

RELATED APPLICATIONS

This application is a Divisional of U.S. patent application Ser. No.09/870,516, filed Jun.1, 2001 now U.S. Pat. No. 6,676,640, which is aContinuation of U.S. patent application Ser. No. 09/177,820, filed Oct.23, 1998, now U.S. Pat. No. 6,287,281, which is a Continuation-in-Partof U.S. patent application Ser. No. 09/109,101, filed Jul. 2, 1998 nowabandoned.

FIELD OF THE INVENTION

The present invention relates to medical devices for the retention offlexible tubes such as gastrostomy feeding tubes.

BACKGROUND OF THE INVENTION

Various medical procedures result in the placement of flexible tubeswithin the body. While the distal end of such tubes remains implantedwithin the body, the proximal end extends outside of the body and mustbe retained.

For example, a gastrostomy (i.e., percutaneous endoscopic gastrostomy,surgically placed gastrostomy tube, or laparoscopically placedgastrostomy tube) is performed in order to place a gastrostomy or“feeding” tube into a patient's stomach. The patient is fed directlythrough the feeding tube via the proximal end of the tube, which extendsfrom the patient's body through a stoma site. This procedure is used forlong-term feeding and to retain digestive functions of patientssuffering from neurological disease, brain injury, or tumors and/orinjuries of the head, neck, or esophagus, who thus have swallowingdifficulties but otherwise have functioning gastrointestinal tracts.

Another type of medical tube placed within the body are drainagecatheters, which are used in interventional radiology to drain fluidsfrom an organ or body cavity. The proximal end of the catheter extendsout of the body and typically has a plastic hub, which is attached andsecured to the patient.

The proximal ends of tubes such as gastrostomy tubes and drainagecatheters must be retained in a fixed position outside of the body toavoid movement into or out of the body and to provide support forfeeding procedures and external manipulation. Furthermore, the ends mustbe closed to prevent the leakage of body fluids from these tubes.Conventional retention systems use multiple components and arecumbersome to use due to inefficient ergonomics. Moreover, conventionalretention systems often do not provide sufficient retention strength.

SUMMARY OF THE INVENTION

The present invention includes medical devices for retaining an end of amedical tube. Each of the devices of the present invention comprises abase and at least one tab having a portion that is moveable within thebase. The base comprises an upper surface, a lower surface, at least oneside cavity for receiving a tab, and an opening in at least one of theupper and lower surfaces. To facilitate tube retention, the tube isinserted through the opening in the base and the tab(s) is(are) movedwithin the cavity(ies) such that a portion of each tab contacts andretains the tube.

In one embodiment, the present invention includes a medical devicecomprising a base and a first tab having a portion that is moveablewithin the base. The base includes a first locking base feature forengaging the first tab. The upper and lower surfaces of the base definea first side cavity between the upper and lower surfaces. The first tabhas a portion that is movable within the first side cavity, a firstlocking tab feature that is engagable with the first locking-basefeature, and a first tube compression member extending from the distalend of the first tab. To facilitate tube retention, the tube is insertedthrough the opening in the base, the first tab is moved within the firstside cavity, and the first locking tab feature is engaged with the firstlocking base feature such that the tab is locked into the base and thefirst tube compression member contacts the tube.

In another embodiment of the present invention, the base includes asecond side cavity between the upper and lower surfaces, and a secondlocking base feature. In this embodiment, the medical device includes asecond tab having a portion that is movable within the second sidecavity. The second tab includes a second locking tab feature that isengagable with the second locking base feature, and further includes asecond tube compression member extending from the distal end of thesecond tab. To facilitate tube retention, the tube is inserted throughthe opening in the base, the first and second tabs are moved within thefirst and second side cavities, respectively, and the first and secondlocking tab features are engaged with the first and second locking basefeatures, respectively, such that the tabs are locked into the base andthe first and second tube compression members contact the tube.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an exploded view of the components of an embodiment of thepresent invention in which two tabs are used.

FIG. 2 shows a cross-sectional view of an embodiment of the presentinvention when in use.

FIG. 3 shows a cross-sectional view of an embodiment of the presentinvention when in use with an external feeding tube insertedtherethrough.

FIG. 4 shows an assembled embodiment of the present invention.

FIG. 5 shows an embodiment of the present invention that includes a boothaving an attached plug.

FIG. 6 shows a patterned boot, for use with an embodiment of the presentinvention.

FIG. 7 shows a top view of an embodiment of the present invention inwhich two tabs are used.

FIG. 8 shows a stem with a mechanical surface thereon, in accordancewith an embodiment of the present invention.

FIG. 9 shows a perspective view of an embodiment of the presentinvention in which the base and tab portions are substantially mirrorimages of each other.

FIGS. 10A and 10B show top and bottom views, respectively, of the baseof an embodiment of the present invention.

FIG. 11 shows a perspective view of the base of an embodiment of thepresent invention in which one tab is used.

FIG. 12 shows a cross-sectional view of a single-tab embodiment of thepresent invention, when in use.

FIG. 13 shows a side view of an embodiment of the present invention inwhich a stem is attached to the base.

FIG. 14 shows a perspective view of an embodiment of the presentinvention in which a stem is attached to the base.

FIG. 15 shows a perspective view of a tab embodiment of the presentinvention.

DETAILED DESCRIPTION

The present invention relates to the retention of flexible plastic tubesat desired locations and orientations in medical applications. Themedical devices of the present invention are suitable for use in anyapplication in which a flexible tube extends from the body and must beretained. Such applications include, for example, gastrostomy tubes,jejunostomy tubes, and drainage catheters (e.g., nephrostomy, abscess,urinary, and biliary drainage, and other multipurpose drainageapplications). The medical devices of the present invention retain andsupport the ends of these tubes when protruding from the body. Themedical devices of the present invention are low profile and thus easilyfit beneath a patient's clothing. Furthermore, the medical devices ofthe present invention are easy to use and provide high retentionstrength. A further advantage of the medical devices of the presentinvention is that they provide a novel and reliable valve and feedingsystem interface.

One embodiment of the present invention, including its variouscomponents, is shown in FIG. 1. The medical device 200 includes a base210, a first tab 230, a second tab 240 and a stem 250.

The base 210 includes upper and lower surfaces 211, 212, and proximaland distal ends 213, 214. The upper and lower surfaces 211, 212 definean opening 215 for receiving a tube to be retained. The upper and lowersurfaces 211, 212 further define a first side cavity 216 and a secondside cavity 217. The first side cavity 216 extends from the opening 215to the proximal end 213. The second side cavity 217 extends from theopening 215 to the distal end 214. In this embodiment, the base 210includes a plurality of first locking base features 218 in the uppersurface 211 between the opening 215 and the proximal end 213. The base210 further includes a plurality of second locking members 219 in theupper surface 211 between the opening 215 and the distal end 214.

The medical device 200 includes first and second tabs 230, 240, whichare substantially identical in structure. The first and second tabs 230,240 are movable within first and second cavities 216, 217, respectively.The first and second tabs 230, 240 comprise respective upper 231, 241and lower 232, 242 surfaces. The upper surfaces 231, 241 each have atleast one locking tab feature 235, 245 that is (are) engagable withrespective locking base features 218, 219. The first and second tabs230, 240 further comprise tube compression members 236, 246 and windowlocking members (shown as 248 for the second tab 240) extending fromdistal ends 234, 244, respectively. The first and second tabs 230, 240each optionally include respective tube closing members (shown as 247for the second tab 240). The base 210 and tabs 230, 240 are made fromany suitable material that provides sufficient strength for the intendedapplication yet allows the locking base features 218, 219 and/or lockingtab features 235, 245 to flex for engagement with each other. Preferredmaterials for the base 210 and tabs 230, 240 include polypropylene,acrylonitrile butadiene styrene, polycarbonate, polyethylene, andmixtures and copolymers thereof.

The stem 250 includes a tubular bottom portion 251 which comprises acylindrical side wall, a top end 252 and a bottom end 253; and apositioning member 254 at the top end 252 of the tubular bottom portion251. The positioning member 254 includes an opening that is coaxial withthe tubular bottom portion 251. Optionally, at least one retentionwindow 255 is located within the cylindrical side wall of the bottomportion 251. The stem 250 is made from any suitable material such as,for example, metallic materials such as stainless steel, copper,nitinol, or brass; and polymeric materials such as polypropylene,acrylonitrile butadiene styrene, polycarbonate, polyethylene, andmixtures and copolymers thereof. It is generally preferred, however,that the stem 250 comprise a metallic material.

The operation of the medical device 200 is now described with referenceto FIGS. 1 to 3. A distal end of a tube 500 to be retained (e.g., agastrostomy feeding tube) is positioned to a desired location within thebody (e.g., the stomach) such that the proximal end extends from theexterior of the body (e.g., through a stoma site). A hemostat is thenclipped to the tube, which is thereafter cut to a suitable length tothereby leave a short stub in which the stem 250 is inserted. The stem250 is inserted into the proximal end 501 of the tube 500 such that thebottom portion 251 is substantially surrounded by the innercircumference of the tube 500. The outer diameter of the bottom portion251 is preferably about the same or greater size than the inner diameterof the tube 500, thus ensuring a tight fit between the two. Thepositioning member 254 remains outside of the tube and is preferablyplaced against the proximal end of the tube when in use.

The opening 215 in the base 210 is configured to receive the tube 500with the stem 250 therein. As shown in FIG. 1, the opening 215 in thelower surface 212 of the base 210 preferably has a shape that reflectsthe shape of the positioning member 254. The base 210 is placed over thetube such that the stem 250 passes through the opening 215 and extendsbeyond the upper surface 211 of the base 210. The base 210 is thenrotated so that, when released, the positioning member 254 will restagainst the upper surface 211 of the base 210. In the embodiment shownin FIG. 1, the base 210 is rotated 90° such that the positioning member254 rests in alignment recesses 220 in the upper surface 211 of the base210. The alignment recesses 220 serve the addition function of aligningretention windows 255, if present, with the window locking members 238,248 on the first and second tabs 230, 240, respectively.

After the tube is inserted through the base 210 and the positioningmember 254 of the stem 250 is resting against the upper surface 211 ofthe base 210, the first and second tabs 230, 240 are moved within firstand second cavities 216, 217, respectively, towards the opening 215 inthe base 210 such that the locking tab features 235, 245 engage with thelocking base features 218, 219, respectively. When fully inserted, thefirst and second tabs 230, 240 hold the tube 500 by compression with thetube compression members 236, 246 and, preferably, with the windowlocking members 238, 248. As shown in cross-section in FIG. 2, thewindow locking members 238, 248 force the tube 500 into the retentionwindows 255 when the first and second tabs 230, 240 are fully insertedinto the first and second cavities 216, 217. When deployed, the devicerests against a patients skin 280, as shown in FIG. 2.

When tube closing members 237, 247 are included in first and second tabs230, 240, they form a “valve” by substantially closing or pinching offthe tube 500, as shown in FIG. 2. One of the effects of this valve is toprevent the discharge of material from within the body through the tube500. It is thus preferred that the tube closing members 237, 247 aresized such that, when the first and second tabs 230, 240 are fullyinserted into first and second cavities 216, 217, the gap between thetube closing members 237, 247 is approximately equal to or less thantwice the wall thickness of the tube. The formation of this internalvalve represents a significant enhancement over conventional retentionsystems, in which external valves add to the complexity of such systems.

When the device 200 is used as part of a feeding system, an externalfeeding tube 510 is engaged with the device 200 as shown in FIG. 3. Theexternal feeding tube 510 includes a portion that extends through thevalve formed by the tube closing members 237, 247 by compressing thesides of the tube 500 against the tube closing members 237, 247, asshown in FIG. 3. The extension member is preferably made from a rigidmaterial, such as stainless steel.

The medical device 200 preferably includes a boot 270 that fits over thebase 210 and first and second tabs 230, 240 when inserted into the base210. If used, the boot 270 rests against the patient's skin, and is thuspreferably made from a soft, elastomeric material such as silicone,polyurethane or latex. If a boot is not used with the present invention,it is preferred that a pad made from a soft, elastic material such assilicone, polyurethane or latex, be placed between the patient's skinand the base 210. Such a pad optionally includes an adhesive material onone or both sides.

When the boot 270 is used with the present invention, the medical deviceis delivered to the physician or patient as shown in FIG. 4. As such,the medical device 200 is simply positioned over the tube preferablyhaving a stem 250 therein, the tube is positioned onto the upper surface211 of the base 210, and the first and second tabs 230, 240 are fullyinserted into the first and second cavities 216, 217, respectively, tolock the tube into the medical device 200. The boot includes upper andlower openings 271, 272 so that the tube can be inserted into theopening 215 in the base 210, and an external feeding tube can beinserted into the stem 250 for feeding the patient. The boot optionallyincludes a plug 273 attached to the boot 270 by an arm member 274 asshown in FIG. 5. The plug 273 is insertable into the end of the tube toprevent the flow of bodily fluids therefrom. In one embodiment, the plug273 acts like a cap that closes the stem lumen when not in use. Inanother embodiment, the plug 273 includes a slit 275 that acts like avalve that can be opened by the insertion of a feeding tube.

The bottom surface of the boot (i.e., the surface that comes intocontact with the patient's skin) is preferably patterned with recesses,grooves, or the like (FIG. 6) to minimize the contact area between theboot and the patient. The boot also optionally includes flap(s) orear(s) 276 extending outward from the bottom surface, as shown in FIG.6. Such flaps 276 are attached to the boot 270 or are formed as anintegral part thereof, and are positioned on the bottom surface of theboot 270 at any suitable location, such as the corners as shown in FIG.6. Preferably, the boot 270 is formed with a flap 276 at each corner ofits bottom surface. The flaps 276 are used to secure (e.g., by suture)the boot 270 to the patient's skin, thereby holding the medical device200 in place during use.

The present invention includes several embodiments that are variationsof the embodiment shown in FIG. 1. For example, the device 300 shown inFIG. 7 (top view) includes a base member 310 having base locking members318, 319 that are positioned on the sides of the base member 310.Although the base locking members 318, 319 are shown in FIG. 7 to extendthrough the base member 310, the base locking members 318, 319 maysimply comprise notches on the inner surface of the base member 310.Correspondingly, the first and second tabs 330, 340 each have at leastone locking tab feature 335, 345 that is (are) engagable with respectivelocking base features 318, 319, as shown in FIG. 7. For example, thelocking tab features 335, 345 snap into the respective locking basefeatures 318, 319 when the tabs 330, 340 are advanced to a workingconfiguration. Although not shown in FIG. 7, the tabs 330, 340 furthercomprise tube compression members and window locking members, andpreferably include tube closing members, as shown for tabs 230, 240 inFIG. 1.

In another embodiment, the present invention includes a stem 350, asection of which is shown in FIG. 8, rather than the stem 250. Like thestem 250, the stem 350 is designed to be inserted into the end of a tubeto be retained. The stem 350 includes a tubular bottom portion 351 whichcomprises a cylindrical side wall, a top end 352 and a bottom end 353;and a positioning member 354 at the top end 352 of said tubular bottomportion 351. The positioning member 354 includes an opening that iscoaxial with the tubular bottom portion 351. The outer diameter of thebottom portion 351 is preferably about the same or greater size than theinner diameter of a tube to be retained. The stem 350 further includes amechanical surface 355, such as a threaded or patterned surface, toassist in gripping and holding a retained tube (as compared to thewindow 255 of the stem 250). When stem 350 is used in the presentinvention, first and second tabs 230, 240 do not include window lockingmembers 238, 248.

FIG. 9 shows an embodiment of the present invention in which the medicaldevice includes only one tab. In this embodiment, the medical device 600includes a base 610 and a first tab 630 that are substantially mirrorimages of each other. The base 610, shown in FIGS. 10A (top view) and10B (bottom view) includes an upper surface 611 and a lower surface 612,which define an opening 615 for receiving a tube. The upper and lowersurfaces 611, 612 further define a first side cavity 616 extending fromthe lower surface 612 of the base 610 and between the side walls 621.The base 610 includes a plurality of locking base teeth 618 in the lowersurface 612.

The medical device 600 includes a first tab 630 that is substantiallyidentical to the base 610. The first tab 630 is movable within the firstside cavity 616 in the base 610. The first tab 630 includes a pluralityof locking tab teeth that are substantially identical to the pluralityof locking base teeth 618 as shown in FIG. 10B. The locking tab teethare engagable with the locking base teeth when the first tab 630 ismoved within the first side cavity 616. Both the base 610 and the firsttab 630 preferably include at least one longitudinally extending ridge(shown as 619 for the base) that is engagable with respectivecorresponding grooves 620, 640 in respective side walls 621, 641.

A tube to be retained by the medical device 600 is inserted through theopening 615 after the first tab 630 has been partially inserted into thefirst side cavity 616 of the base 610. To complete retention, the firsttab 630 is fully inserted into the first side cavity 616 of the base610, to thereby exert a compressive force on a tube within the opening615. The first tab 630 is held in position by the engagement of thelocking tab teeth with the locking base teeth. In one embodiment, thetube to be retained has a stem inserted therein to help facilitate tuberetention, as previously described for stems 250 and 350. In anotherembodiment, the tube to be retained is held and pinched by the relativemovement of the base 610 and the tab 630. In this embodiment, the tubeto be retained preferably has a diameter larger than that of the opening615 such that when the first tab 630 is fully inserted into the base610, it is pinched at intersections 625 on either side of the opening615. As such, when the first tab 630 is fully inserted into the base610, a valve is formed to thereby substantially close the tube withinthe opening 615.

Another embodiment 700 of the present invention which makes use of asingle tab is shown in FIG. 11. This embodiment includes a base 710having an upper surface 711, a lower surface 712, a proximal end 713 anda distal end 714. The upper and lower surfaces 711, 712 define anopening 715 for receiving a tube. The upper and lower surfaces 711, 712further define a first side cavity 716 extending from the opening 715 tothe proximal end 713. The base 710 includes a plurality of first lockingbase features 718 in the upper surface 711 between the opening 715 andthe proximal end 713. The base 710 also includes many of the featureswhich would otherwise be present in a second tab, if used. For example,base 710 includes a tube compression member 746 and a window lockingmember 748 extending from its distal end 714. The base 710 optionallyincludes a tube closing members 747, also extending from its distal end714.

The medical device 700 includes a first tab, such as that shown as 230in FIG. 1. Tube retention is accomplished in the same manner asdescribed for the medical device 200, with the exception that a secondtab is not used. A cross-section of the device 700 is shown in FIG. 12,wherein the first tab 230 is inserted into the first side cavity 716 andthe device 700 is used to retain a tube 500.

Another embodiment of the present invention in which a stem is attachedto the base is shown in FIG. 13. In this embodiment 800, the base 810includes an upper surface 811, a lower surface 812, and a stem 850extending from the upper surface 811 towards an opening 815 in the lowersurface 812. The stem 850 is characterized by a cylindrical profile thatincludes, for the embodiment shown in FIG. 13, a first cylindricalportion 851 adjacent the upper surface 811, a second cylindrical portion852 adjacent the first cylindrical portion, and a third cylindricalportion 853 adjacent the second cylindrical portion. The secondcylindrical portion 852 preferably has a diameter greater than either ofthe first or third cylindrical portions 851, 853. The stem 850 ispreferably formed as an integral part of the base 810, such as bymolding. The stem 850 preferably extends from the upper surface 811through the opening 815 in the lower surface 812. The stem 850 alsopreferably includes a valve housing 0.854 extending through the uppersurface 811.

Embodiment 800 includes a first side cavity 816, a second side cavity817, first locking base members 818, and second locking base member 819,as shown in FIG. 14. Also included are first and second tabs that aresubstantially identical in structure, such as the tab 830 shown in FIG.15, that are moveable within the first and second side cavities 816,817. The tab 830 includes at least one locking tab feature 835 that is(are) engagable with respective locking base features 818 or 819. Thetab 830 further includes a tube compression member 846 that conforms toat least part of the cylindrical profile of the stem 850.

When the device 800 is in use, a tube to be retained is placed throughthe opening 815 and over the stem 850. The tube preferably is placedover the stem 850 until it abuts either the upper surface 811 of thebody 810 or, if used, the valve housing 854. After the tube is sopositioned, the first and second tabs are moved within the first andsecond cavities 816, 817 such that the locking tab features, such as835, engage with the locking base features, such as 818. When fullyinserted, the first and second tabs hold the tube by compression withthe tube compression members, such as 846, which conform in shape to atleast part of the cylindrical profile of the stem 850.

The dimensions of the devices of the present invention are limited onlyby manufacturing capabilities. The devices and their respectivecomponents are made by suitable methods known to those of skill in theart, such as injection molding, casting, machining, and the like. Thedevices are sized to fit, for example, feeding tubes of size #5 to #24French, but can be sized for any other tube sizes by appropriate sizesof the base, tab(s) and stem.

The present invention provides for the low profile retention of flexibletubes that extend from the body as a result of any one of a number ofmedical procedures. The medical devices of the present invention areeasy to use, provide a high retention strength, and provide a reliablevalve and feeding system interface. Although the present invention hasbeen described with respect to several exemplary embodiments, there aremany other variations of the above-described embodiments which will beapparent to those skilled in the art, even where elements have notexplicitly been designated as exemplary. It is understood that thesemodifications are within the teaching of the present invention, which isto be limited only by the claims appended hereto.

1. A medical device for retaining an end of a tube, wherein the medicaldevice comprises: a base comprising an upper surface, a lower surface,and an opening for receiving said tube, said base comprising a firstlocking base feature; a stem comprising a bottom portion insertable intothe end of said tube, wherein when said medical device is in anassembled configuration, said bottom portion of said stem is placed intothe end of said tube, said tube is placed into said opening in saidbase, and said bottom portion of said stem projects toward said lowersurface of said base; and a first tab movable with respect to said basefor compressing the tube, said first tab comprising a first locking tabfeature; wherein said first locking tab feature is engagable with saidfirst locking base feature to hold the first tab in a fixed positionwith respect to the base.
 2. The medical device of claim 1, wherein saidfirst locking base feature comprises a first plurality of teeth on saidbase; and said plurality of teeth on said base are engagable with saidfirst locking tab feature.
 3. The medical device of claim 1, whereinsaid first locking tab feature comprises a plurality of teeth on saidfirst tab; and said plurality of teeth on said first tab are engagablewith said first locking base feature.
 4. The medical device of claim 1,wherein said first locking base feature comprises a locking opening insaid base; said first locking tab feature comprises a locking memberextending from said first tab; and said locking member is engagable withsaid locking opening.
 5. The medical device of claim 1, wherein saidfirst tab comprises a first tube compression member, and when said firstlocking tab feature is engaged with said first locking base feature,said first tube compression member comes into contact with said tube. 6.The medical device of claim 1, said stem further comprising apositioning member at the top end of said bottom portion, saidpositioning member defining an opening coaxial with said bottom portion;wherein when said medical device is in use, said positioning memberrests against said base.
 7. The medical device of claim 6, wherein saidbottom portion of said stem comprises a tubular bottom portioncomprising a cylindrical side wall, the cylindrical side wall of saidtubular bottom portion defines a retention window; and when said firstlocking tab feature is engaged with said first locking base feature,said tube compression forces at least part of said tube into saidretention window.
 8. The medical device of claim 6, wherein said bottomportion of said stem comprises a tubular bottom portion comprising acylindrical side wall and said cylindrical side wall has a mechanicalsurface thereon.
 9. The medical device of claim 6, wherein said baseincludes an alignment recess; and when said medical device is in use,said positioning member rests within said alignment recess.
 10. Themedical device of claim 6, further comprising a feeding tube interfaceover said stem.
 11. The medical device of claim 1, wherein said stem isattached to said base.
 12. The medical device of claim 11, wherein saidstem comprises: a first cylindrical portion adjacent a position wheresaid stem is attached to said base; a second cylindrical portionadjacent said first cylindrical portion; and a third cylindrical portionadjacent said second cylindrical portion; wherein said secondcylindrical portion has a diameter greater than either of said first orthird cylindrical portions.
 13. The medical device of claim 12, whereinwhen said medical device is in use, said tube is placed over each ofsaid first, second and third cylindrical portions.
 14. The medicaldevice of claim 11, wherein said stem further comprises a valve housing.15. A medical device for retaining an end of a tube, wherein the medicaldevice comprises: a base for receiving said tube, said base comprising afirst locking base feature and a second locking base feature; a firsttab movable with respect to said base to a first tab compressionposition in which said first tab compresses the tube at a firstcompression location, said first tab comprising a first locking tabfeature, wherein said first locking tab feature is engagable with saidfirst locking base feature to hold the first tab in a fixed positionwith respect to the base; and a second tab movable with respect to saidbase to a second tab compression position in which said second tabcompresses the tube at a second compression location different from thefirst compression location, said second tab comprising a second lockingtab feature, wherein said second locking tab feature is engagable withsaid second locking base feature to hold the second tab in a fixedposition with respect to the base.
 16. The medical device of claim 15,wherein said second locking base feature comprises a second plurality ofteeth on said base; and said second plurality of teeth on said base areengagable with said second locking tab feature.
 17. The medical deviceof claim 15, wherein said second locking tab feature comprises aplurality of teeth on said second tab; and said plurality of teeth onsaid second tab are engagable with said second locking base feature. 18.The medical device of claim 15, wherein said second locking base featurecomprises a locking opening in said base; said second locking tabfeature comprises a locking member extending from said second tab; andsaid locking member is engagable with said locking opening.
 19. Themedical device of claim 15, wherein said second tab comprises a secondtube compression member, and when said second locking tab feature isengaged with said second locking base feature, said second tubecompression member comes into contact with said tube.
 20. A medicaldevice for retaining an end of a tube, wherein the medical devicecomprises: a base with an opening for receiving said tube, said basecomprising a first locking base feature; a stem comprising a bottomportion insertable into the end of said tube, wherein when said medicaldevice is in an assembled configuration, said bottom portion of saidstem is placed into the end of said tube, said tube is placed into saidopening in said base, and said bottom portion of said stem projects intosaid opening in said base; and a first tab movable with respect to saidbase for compressing the tube, said first tab comprising a first lockingtab feature; wherein said first locking tab feature is engagable withsaid first locking base feature to hold the first tab in a fixedposition with respect to the base.